抗环瓜氨酸肽抗体和葡萄糖-6-磷酸-异构酶抗原对类风湿关节炎诊断价值的比较

目的评价抗环瓜氨酸肽（CCP）抗体和葡萄糖-6-磷酸-异构酶（GPI）抗原对类风湿关节炎（RA）的诊断价值。方法用酶联免疫吸附试验（ELISA）法分别测定RA患者112例、非RA其他风湿病患者44例以及健康志愿者119名血清中的抗CCP抗体、GPI抗原和IgM—RF，应用ROC比较抗CCP抗体和GPI抗原对RA的诊断价值，用Spearman方法分析上述指标与lgM—RF的相关性。结果在诊断RA时．抗CCP抗体和GPI抗原的ROC曲线下面积均大于IgM—RF（P均〈0．05）。抗CCP抗体、GPI抗原与IgM—RF显著相关。CCP抗体与GPI抗原的联合试验的灵敏度达到0．946。结论联合测定抗CCP抗体和GPI抗原对RA具有较高的诊断价值，具有良好的应用前景。     

抗突变型瓜氨酸波形蛋白抗体葡萄糖-6-磷酸异构酶和抗环瓜氨酸多肽抗体检测在类风湿关节炎诊断中的价值

目的 了解抗突变型瓜氨酸波形蛋白(MCV)抗体、葡萄糖-6-磷酸异构酶(GPI)、抗环瓜氨酸多肽(CCP)抗体检测在类风湿关节炎(RA)诊断中的价值.方法 检测109例RA患者,24例其他风湿病患者及19名健康对照血清中抗MCV抗体、GPI和抗CCP抗体,比较3种抗体单独或联合检测对诊断RA的敏感性和特异性.结果 RA组抗MCV抗体和GPI阳性率及平均浓度显著高于其他风湿病组及健康对照组(P<0.05).抗CCP抗体与GPI阳性率在RA患者中的差异有统计学意义.抗MCV抗体对RA敏感性最高(99.1%);抗CCP抗体对RA特异性最高(90.7%);联合检测以MCV+CCP、MCV+GPI以及MCV+CCP+GPI特异件最高(均为98.1%).结论 单独或联合检测抗MCV抗体、抗CCP抗体和GPI,有助于提高RA诊断的敏感性和特异性.     

血清葡萄糖6-磷酸异构酶抗原、类风湿因子和第2代抗环瓜氨酸肽抗体对类风湿关节炎诊断价值的比较

目的 检测葡萄糖6-磷酸异构酶（glucose-6-phosphate isomerase,GPI）抗原在类风湿关节炎（rheumatoid arthritis,RA）中的表达情况,并比较其与类风湿因子（rheumatoid factor,RF）和第2代抗环瓜氨酸肽（the second generation of anti-cyclic citrullinated peptide,抗CCP2）抗体对RA的诊断价值.方法 采用酶联免疫吸附试验检测126例RA和122例非RA患者血清GPI抗原和抗CCP2抗体,速率散射比浊法检测RF.结果 血清GPI浓度在RA患者较非RA组显著增高,差异有统计学意义[（0.28±0.65） mg/L vs.（0.07±0.36） mg/L,P〈0.005].GPI对RA的诊断敏感性为32.5%,低于RF（69.0%）和抗CCP2抗体（72.2%）的诊断敏感性,差异均有显著统计学意义（P〈0.001）;GPI、RF和抗CCP2抗体对RA的诊断特异性分别为89.3%、87.7%和95.1%,差异无显著统计学意义（P〉0.05）.与单一检测抗CCP2抗体比较,GPI及RF同时阳性、GPI及抗CCP2抗体同时阳性、以及GPI、RF及抗CCP2抗体三项同时阳性的诊断敏感性降低;而GPI或RF、GPI或抗CCP2、以及GPI或RF或抗CCP2单一阳性的诊断特异性降低,均有显著统计学意义（P＜0.05）.结论 血清GPI对RA诊断的敏感性低,可与高敏感性的抗CCP2抗体联合检测.     

抗环瓜氨酸肽抗体与抗Sa抗体联合检测对类风湿关节炎的意义

类风湿关节炎 (rheumatoidarthritis,RA)是一种致畸性疾病 ,3年内 70 %的患者出现骨关节影像学改变 ,早期诊断早期给予缓解病情药可以减少骨关节破坏并改善预后。自从 196 4年发现抗核周因子 (APF)是RA的特异性抗体后 ,又陆续发现抗角蛋白抗体 (AKA)、抗纤聚蛋白抗体 (AFA)以及抗Sa抗体[1,2 ] 、抗环瓜氨酸肽抗体[3 ] (抗CCP抗体 )。有资料表明 ,抗Sa抗体对RA的敏感性 37%～ 4 3% ,抗CCP抗体对RA的敏感性 4 0 %～ 5 0 % ,将两者联合检测能否提高诊断敏感性及特异性 ?本文将探讨抗Sa抗体与抗CCP抗体的相关性及联合诊断对RA的意…     

葡萄糖-6-磷酸异构酶抗原对类风湿关节炎诊断的意义

目的 研究葡萄糖-6-磷酸异构酶(G6PI)抗原在类风湿关节炎(RA)中的诊断意义.方法 用酶联免疫吸附试验(ELISA)双抗体夹心法检测106例RA患者,53例其他风湿性疾病和35名健康志愿者血清中的G6PI抗原的分布.还同时检测了类风湿因子(IgM-RF)、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA)、C反应蛋白(CRP)、红细胞沉降率(ESR).并对98例RA患者行手足x线片,将其按修正的Sharp评分,分为有骨侵蚀组与无骨侵蚀组.结果 ①RA患者血清中G6PI浓度显著高于其他风湿病组和健康对照组(P<0.05).检测G6PI对RA的诊断价值,采用受试者工作曲线(ROC),诊断RA的最佳临界值为0.225μg/ml,此时的灵敏性为0.868,特异性为0.853.②G6PI与IgM-RF之间具有相关性(rs=0.504,P<0.05),G6PI与抗CCP抗体之间未显示出相关性(rs=0.078,P=0.503).③通过Spearman相关性分析.未发现G6PI抗原与病情活动性指标如ESR、CRP等有相关性.④经单因素分析G6PI抗原与骨侵蚀无关(P<0.05),IgM-RF与骨侵蚀具有相关性(P<0.05).结论 G6PI抗原在部分RA患者血清中显著升高,抗G6PI抗原对RA具有良好的敏感性(86.8%)和特异性(85.3%),能作为RA患者的一种新的标志物.G6PI抗原与IgM-RF有相关性,但不完全重叠.此研究未发现G6PI与病情活动性指标及关节侵蚀之间有关联.     

类风湿关节炎活动期滑液中葡萄糖6-磷酸异构酶水平及与抗环瓜氨酸肽抗体的关系

目的 检测葡萄糖-6-磷酸异构酶(GPI)在类风湿关节炎(RA)活动期膝关节滑液中的含量,并探讨滑液中GPI与抗环瓜氨酸肽(CCP)抗体的关系.方法 用酶联免疫吸附法(ELISA)检测22例RA活动期患者和37例骨关节炎活动期患者滑液中GPI和抗CCP抗体的浓度.组间比较采用t检验,相关性分析采用Spearman相关分析.结果 RA活动期患者膝关节滑液中的GPI浓度高于骨关节炎活动期患者[(9.6±8.4)和(0.9±1.8)μg/ml],差异有统计学意义(P＜0.01);RA活动期患者与骨关节炎活动期患者滑液的抗CCP抗体浓度分别为(14.61±18.64)和(1.42:±0.09) U/ml,差异有统计学意义(P＜0.01);RA活动期患者膝关节滑液中GPI含量和抗CCP抗体浓度呈正相关(r=0.447,P=0.037).结论 GPI在RA活动期患者滑液中高表达,可能与RA发生发展过程中慢性滑膜炎、骨质破坏有关.GPI与抗CCP抗体呈正相关,两者可作为RA实验室诊断的参考指标.     

抗环瓜氨酸肽抗体联合类风湿因子检测对类风湿性关节炎诊断的临床价值

目的探讨联合检测抗环瓜氨酸肽抗体（anti-CCP）与类风湿因子（RF）对类风湿关节炎（RA）早期诊断的意义。方法选取2008年1月—2009年1月收治确诊RA患者中随机抽取100人作为RA组,以健康人50例作为对照组,采用酶联免疫吸附法（ELISA）检测抗CCP抗体,采用速率散射比浊法检测RF。结果RA组的anti-CCP阳性率为67%,RF的阳性率为78%。对比分析发现RA患者血清中的anti-CCP对RA诊断的灵敏度比RF的灵敏度低,差异具有显著性（P〈0.05）;而anti-CCP的96.0%的特异性比RF的88.0%要高,差异具有显著性（P〈0.05）。两者联合检测灵敏度可提高,特异性可达100.0%。结论RF与anti-CCP联合使用可进一步提高RA诊断的灵敏度和特异性,有利于对RA的早期检出。     

血清葡萄糖-6-磷酸异构酶在类风湿性关节炎中的应用

目的：探讨血清中葡萄糖-6磷酸异构酶（G6PI）对类风湿性关节炎（RA）诊断及与其他自身免疫性疾病鉴别诊断中的价值。方法：采用酶联免疫吸附试验（ELISA）检测137例RA患者、141例其他风湿病患者和60例健康对照血清中GPI抗原的浓度,RA患者还检测了抗环胍氨酸肽抗体（抗CCP抗体）及类风湿因子（RF）的浓度。结果：137例RA患者血清中GPI浓度为（3．01±1．33）mg／L,141例其他风湿性疾病组为（0．27±0．16）mg／L,60例健康对照组为（0．07±0．03）mg／L。RA患者血清中GPI浓度显著高于其他风湿病组和健康对照组（P〈0．01）;在RA活动组和RA非活动组中亦差异有统计学意义（P〈0．01）。GPI抗原对RA诊断的敏感性为62．8％,特异性为95．7％。3个指标联合检测的特异性达100％。结论：GPI在部分RA患者血清中显著升高,有可能成为诊断RA及判断其疾病活动性的一个新指标。     

血清抗角蛋白抗体抗环瓜氨酸肽抗体和类风湿因子在类风湿关节炎中的意义

目的 评价抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在类风湿关节炎(RA)中的意义.方法 收集82例RA患者及56例非RA患者,测定其抗CCP抗体、AKA和RF水平,评价对RA诊断的敏感性、特异性,比较RA患者中抗CCP抗体、AKA阳性组和阴性组的压痛关节数、肿胀关节数、红细胞沉降率(ESR)、C反应蛋白(CRP)、疾病活动指数(DAS)、Ritchie's指数(RAI).结果 单独检测AKA、抗CCP抗体、RF及联合检测的曲线下面积都较高(P<0.05).抗CCP抗体、AKA的特异度分别为92.9%、91.1%,联合检测AKA、抗CCP抗体和RF有任何一种及以上阳性的灵敏度最高,为95.1%.抗CCP抗体阳性组与阴性组的关节肿胀数、关节压痛数、ESR、CRP、DAS、RAI差异有统计学意义(P<0.05);AKA阳性组与阴性组的关节肿胀数、ESR、DSA差异均有统计学意义(P<0.05).结论 联合检测抗CCP抗体、RF、AKA对诊断RA有意义,抗CCP抗体、AKA可能与RA的活动度相关.     

抗环瓜氨酸肽抗体对类风湿关节炎和丙型肝炎相关关节病鉴别诊断的意义

目的检测血清抗环瓜氨酸肽抗体（抗CCP抗体）和类风湿因子（RF）在类风湿关节炎（RA）和丙型肝炎病毒（HCV）相关关节病中的阳性率，探讨抗CCP抗体检测在RA和HCV相关关节病鉴别诊断中的意义。方法42例RA和38例HCV感染患者作为研究对象；30名健康体检者为正常对照组。采用酶联免疫吸附试验（ELISA）定量检测抗CCP抗体浓度，采用免疫散射比浊法定量测定RF浓度。结果血清抗CCP抗体在RA组阳性率为86％（36／42），而在HCV感染组和正常对照组均为阴性。同HCV感染组和正常对照组相比，RA组血清抗CCP抗体水平差异有统计学意义（86％ VS 0，P〈0.01）。血清RF在RA组阳性率为79％（33／42）：HCV感染组阳性率是42％（16／38），健康对照组阳性率是7％（2／30）。而在16例RF阳性HCV感染患者中，HCV相关关节病占81％（13／16），无关节受累者占19％（3／16）；13例HCV相关关节病中，多关节痛者占85％（11／13），RA样多关节受累者占15％（2／13）；RF在HCV相关关节病与RA之间差异无统计学意义（81％ VS 79％，19〉0．05）。结论血清抗CCP抗体测定更有助于RA与HCV相关关节病的鉴别诊断。     

四种抗体联合检测在类风湿关节炎早期诊断中的应用价值

目的 探讨抗核周因子抗体(APF)、抗角蛋白抗体(AKA)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗-CCP抗体)联合检测在类风湿关节炎(RA)早期诊断中的临床应用价值。方法 对RA患者127例、非RA其他风湿病患者102例及正常对照组43例，采用速率散射免疫比浊法检测RF；酶联免疫吸附法定量检测抗-CCP抗体；免疫荧光法检测AKA、APF，并采用四格表法计算敏感度及特异性。结果RA组的RF、APF、AKA、抗-CCP抗体敏感度分别为65．4％、48．8％、32．3％、83．5％，特异性分别为73．5％、92．2％、93．1％、94．1％，同时出现三种抗体和四种抗体的特异性为99．0％、100％；非RA组无四种抗体同时出现的情况。结论 RF敏感性较高，但特异性较差；APF、AKA、抗-CCP抗体三种自身抗体对RA具有高度特异性，且在RA早期即可出现。四种抗体联合检测有助于提高RA的早期诊断率。     

The association of anti-CCP antibodies with disease activity in rheumatoid arthritis

Antibodies to citrullinated proteins have been described in patients with rheumatoid arthritis (RA) and these appear to be the most specific markers of the disease. Our objective was to determine the frequency of antibodies to cyclic citrullinated peptides (CCPs) in patients with RA and the association of anti-CCP antibodies with disease activity, radiological erosions and HLA DR genotype. Forty patients with RA and 38 patients with fibromyalgia were included in this study. Serum samples were collected from both patient groups with RA and fibromyalgia. Anti-CCP was measured by the corresponding enzyme-linked immunosorbent assay. Additionally, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), disease activity score (DAS), visual analog scala (VAS), HLA genotype and radiographic information were determined in patients with RA. The rate of sensitivity and specificity of anti-CCP reactivity for the diagnosis RA were measured (sensitivity 50%, specificity 100%). There is no significant difference between anti-CCP (+) and anti-CCP (-) RA patients for DAS28, VAS, ESR, CRP, disease duration, HLA genotype, and radiological assessment of hand. However, there was a significant difference between anti-CCP (+) and anti-CCP (-) RA patients for RF and the radiological assessment of left and right wrists (respectively, P < 0.05, P = 0.04, P = 0.01). There was no significant correlation between anti-CCP antibody and ESR, CRP, VAS, DAS 28 or radiological assessment. A small but significant correlation was found between RF and anti-CCP antibody (P = 0.02, r = 0.35).     

Usefulness of anti-CCP antibodies in patients with hepatitis C virus infection with or without arthritis,rheumatoid factor,or cryoglobulinemia

The presence of antibodies to cyclic citrullinated peptide (CCP) has high specificity in the diagnosis of rheumatoid arthritis (RA). Hepatitis C virus (HCV) infection may induce extra-hepatic manifestations, such as polyarthritis that mimic RA. The aim of this study was to determine the prevalence of anti-CCP antibodies in HCV-infected patients with or without arthritis, rheumatoid factor (RF), or cryoglobulinemia and to investigate whether anti-CCP antibodies may be helpful in discriminating patients with RA from patients with HCV-associated arthropathy. A total of 44 patients with RA, 34 patients with HCV infections, and 42 control patients with non-RA rheumatic diseases were recruited for the study. Anti-CCP antibody levels were determined by enzyme-linked immunosorbent assay. We found that, consistent with other reports, patients with RA were more likely to have high titers of anti-CCP antibody than HCV-infected or control patients. A significant number of HCV-infected patients with neither RF nor cryoglobulinemia were also positive for anti-CCP antibodies (the three positive values were 36.10, 8.65, and 5.83 U/ml, P < 0.01 compared with the control patients). The presence of cryoglobulinemia and/or RF in HCV-infected patients did not affect the anti-CCP outcomes. Although anti-CCP antibodies remain to be a very useful tool in discriminating RA from non-RA, HCV-infected patients with neither RF nor cryoglobulinemia may have anti-CCP antibodies. Because of limited patient numbers, this tentative conclusion may need further confirmation with inclusion of more patient population.     

类风湿关节炎患者抗环瓜氨酸抗体、HLA—DR4基因与其临床特征的关系

目的 探讨抗环胍氨酸（CCP）抗体、人类白细胞抗原HLA-DR4基因与进展性类风湿关节炎（RA）临床特征的关系.方法 记录73例类风湿关节患者的临床资料和实验室检查结果,并采用细胞毒法检测全部病例的HLA-DR4基因携带情况,比较HLA-DR4阳性组与阴性组的临床表现、实验室指标、X线表现及关节功能分级.结果 HLA-DR4阳性者27例,基因频率为37%.HLA-DR4阳性组关节肿胀指数、疼痛指数较高,晨僵持续时间较长,关节功能分级为Ⅲ～Ⅳ级的比例较高,出现骨质破坏比例也较高,抗CCP抗体、类风湿因子、血沉、C反应蛋白值均高于阴性组.结论 HLA-DR4和抗CCP抗体阳性的RA患者与HLA-DR4阴性组的RA患者比较炎症活动严重,且进展较快,应积极治疗.     

Anti-cyclic citrullinated peptide antibody is associated with radiographic erosion in rheumatoid arthritis independently of shared epitope status

Shared epitope (SE) and anti-cyclic citrullinated peptide (CCP) antibody are known to be associated with rheumatoid arthritis (RA). The authors investigated their adjusted effects on RA from Korean population. Clinical features were evaluated in 226 RA patients; 164 healthy controls were enrolled. HLA-DRB1 typing for SE was done by polymerase chain reaction. Anti-CCP antibody levels were determined by enzyme linked immunosorbent assay. Logistic regression analysis method was used for adjusted effects. SE and anti-CCP antibody were associated with RA susceptibility. Anti-CCP antibody was associated with RA susceptibility independent of SE [odds ratio, OR 179.9 (95% confidence interval, CI 40.8–792.2), P < 0.001]. Anti-CCP antibody was associated with radiographic erosive changes independent of SE or rheumatoid factor [OR 3.9 (95% CI 1.1–13.3), P = 0.032]. Anti-CCP antibody was strongly associated with RA susceptibility and radiographic erosion of RA patients, independent of SE in Korean.     

抗环瓜氨酸多肽抗体检测早期诊断类风湿关节炎研究

目的探讨抗环瓜氨酸多肽(CCP)抗体检测对类风湿关节炎(RA)早期诊断的意义。方法应用ELISA法检测2004—2005年中国医科大学附属盛京医院150份人血清的抗CCP抗体,包括54例RA患者,80例其它风湿病患者,16名正常人;并分析抗CCP抗体与类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)的相关性。结果抗CCP抗体对RA的敏感性和特异性分别为70·4%和93·8%。发病2年内与2年以上的抗CCP抗体阳性率差异无显著性。抗CCP抗体阴性组与阳性组的关节畸形率差异无显著性。抗CCP抗体与RF、CRP、ESR无相关性。结论抗CCP抗体对RA具有较好的敏感性和很高的特异性,联合抗CCP抗体和RF可以提高诊断的准确性,对RA的早期诊断具有重要意义。     

Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis

Our aim is to assess the prevalence and associated clinical features of anti-CCP (cyclic citrullinated peptide) antibodies for RF (rheumatoid factor)-positive and RF-negative rheumatoid arthritis (RA) and psoriatic arthritis (PsA). In a prospective, cross-sectional, multi-centre study, we determined the titres of anti-CCP antibodies in 208 RA patients (129 RF-positive, 79 RF-negative), 56 PsA patients and 39 healthy controls (HC). Clinical parameters including disease activity (disease activity score 28-DAS28), physical disability (health assessment questionnaire-HAQ), functional capacity (functional class) and radiological erosions were investigated in patients with RA. In PsA patients, clinical and radiological features were determined. Anti-CCP2 antibodies were measured using a second-generation anti-CCP enzyme-linked immunosorbent assay (Euro-Diagnostica, Netherlands). One-hundred four of 129 RF-positive RA (81%), 16 of 79 RF-negative RA (20%), seven of 56 PsA patients (12.5%) and none of the HC had anti-CCP antibodies. RA patients with anti-CCP antibodies had significantly higher disease activity, greater loss of function and more frequent erosive disease than anti-CCP antibody-negative group. In subgroup analysis, anti-CCP antibodies in RF-negative patients were also associated with erosive disease. All PsA patients with anti-CCP antibodies had symmetric arthritis with higher number of swollen joints. The prevalence of anti-CCP antibodies in RF-positive RA patients was significantly higher than in RF-negative RA and PsA patients. Anti-CCP antibodies were also associated with erosive disease in RF-negative RA patients. Both anti-CCP and RF tests were negative in 30% of the patients. Anti-CCP positivity was a frequent finding in PsA and associated with symmetrical polyarthritis.     

Diagnostic utility of the Elecsys anti-CCP assay in patients with rheumatoid arthritis

Abstract

Objective. The automatic anti-cyclic citrullinated peptide (anti-CCP) antibodies assay offered great advantages over traditional methods in terms of improved precision, reliability, technical simplicity, short turnaround time and high-speed throughput. In this study, we evaluated the main technical performance and diagnostic accuracy of the first automatic anti-CCP assay approved in China.

Methods. The study comprised 106 rheumatoid arthritis (RA) patients, 203 non-RA rheumatic disease controls and 46 healthy persons. Anti-CCP, rheumatoid factor (RF), α₁-acid glycoprotein, C-reactive protein and erythrocyte sedimentation rate were measured and compared. The precision, reference intervals for Chinese population and cut-off value for RA diagnosis, as well as the suitable diluent for anti-CCP were assessed. The positive rate and score of anti-CCP were compared with RF and acute-phase reactants, according to the new RA criteria.

Results. Within- and between-run imprecision, expressed as the coefficient of variation, were 0.47–1.36% and 1.15–2.63%, respectively. Upper 95% reference limit of anti-CCP in healthy Chinese was 8.8 U/mL. The area under curve of the receiver operating characteristic(ROC) for anti-CCP and RF were 0.882 (95% CI 0.833–0.930) and 0.844 (95% CI 0.792–0.897), respectively. Based on the cut-off value set by ROC, compared to RF, anti-CCP had higher sensitivity (96.8% vs. 78.3%) and specificity (90.9% vs. 70.7%). With 17 U/mL set as the optimal cut-off for anti-CCP, the total positivity of anti-CCP was comparable to that of RF (76.4% vs. 75.5%), but the high-positivity rate of anti-CCP was significantly higher (74.5% vs. 62.3%, p < 0.005).

Conclusions. Our results confirm anti-CCP as a more sensitive and specific marker than RF for the diagnosis of RA. The diagnostic performance of the Elecsys anti-CCP assay makes it a useful adjunct to clinical practice in the Chinese population.     

抗环瓜氨酸多肽抗体检测早期诊断类风湿关节炎研究

目的探讨抗环瓜氨酸多肽（CCP）抗体检测对类风湿关节炎（RA）早期诊断的意义。方法应用ELISA法检测2004-2005年中国医科大学附属盛京医院150份人血清的抗CCP抗体，包括54例RA患者，80例其它风湿病患者，16名正常人；并分析抗CCP抗体与类风湿因子（RF）、C反应蛋白（CRP）、血沉（ESR）的相关性。结果抗CCP抗体对RA的敏感性和特异性分别为70．4％和93．8％。发病2年内与2年以上的抗CCP抗体阳性率差异无显著性。抗CCP抗体阴性组与阳性组的关节畸形率差异无显著性。抗CCP抗体与RF、CRP、ESR无相关性。结论抗CCP抗体对RA具有较好的敏感性和很高的特异性，联合抗CCP抗体和RF可以提高诊断的准确性，对RA的早期诊断具有重要意义。     

抗CCP抗体和抗Sa抗体联合检测对老年人RA的临床意义

目的探讨抗环瓜氨酸肽抗体（抗CCP抗体）和抗Sa抗体联合检测对老年人类风湿关节炎（RA）的临床意义。方法检测85例老年人RA患者的抗CCP抗体和抗Sa抗体,结合临床资料分析。结果抗CCP抗体和抗Sa抗体对RA诊断敏感性分别为77．6％和32．9％,特异性分别为97．4％和95．4％。抗CCP抗体、抗Sa抗体、类风湿因子（RF）均阳性组医生对病情评估、患者对病情评估、Sharp评分、ESR及CRP水平均较阴性组增高。24例RF阴性老年人RA中,抗CCP抗体、抗Sa抗体阳性率分别为50％、41．7％。结论抗CCP抗体和抗Sa抗体联合检测有助于老年人RA的诊断,且二者与患者病情活动性及严重性相关。